- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,036.60 / $27,033.20 / $35,295.69
| Facility | | $13,036.60 | $27,033.20 | $35,295.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,686.89 / $66,106.67
| Facility | | $5,840.42 | $24,686.89 | $66,106.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,274.68 / $25,257.02 / $38,163.66
| Facility | | $15,274.68 | $25,257.02 | $38,163.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,867.56 / $35,867.56 / $35,867.56
| Facility | | $35,867.56 | $35,867.56 | $35,867.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,007.83 / $25,444.17 / $39,291.76
| Facility | | $22,007.83 | $25,444.17 | $39,291.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,686.89 / $66,106.67
| Facility | | $5,840.42 | $24,686.89 | $66,106.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,686.89 / $51,662.95
| Facility | | $5,840.42 | $24,686.89 | $51,662.95 |